Surgical technique and usefulness of Retrograde approach to patients with unclear uterine cevixes and with severe adhesion in a cul-de-sac.

Kuramori, Rihoko; Masumoto, Takashi; Hashimoto, Yoshiko; Saeki, Ai; Oku, Hisato; Kuno, Atsushi; Ikuma, K

doi:10.5180/jsgoe.27.272

Cited by 1 publication

(1 citation statement)

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“…In addition to the methods devised by our department, the usefulness of placing an upper abdominal port, preceding enucleating myomectomy, and the use of an electric morcellator for the treatment of large uterine myomas has been previously reported ( 5 ), as has the usefulness of retrograde TLH for the treatment of advanced adhesions and cases with an unclear cervical region ( 6 , 7 ). Regarding large myomas of the uterus, TLH is applicable even for uterine myomas weighing >1,000 g. It has been reported that the rate of switch to laparotomy was 4.2–9.7%, a small incision in the abdominal wall was necessary to extract the specimen in 21% of the cases, and the incidence of complications was 2.8–11.4% ( 3 ).…”

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confidence: 99%

Total laparoscopic hysterectomy for large uterine cervical myoma

Nakayama

Tsukao

Ishikawa

et al. 2017

Molecular and Clinical Oncology

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Abstract. Ureterolysis is a surgical method with a high level of difficulty, which may be necessary when performing total laparoscopic hysterectomy (TLH) for large cervical myoma, despite the benign nature of this tumor. The aim of the present study was to introduce techniques that are commonly applied in malignant tumor surgery in order to safely perform TLH for large cervical myoma. Between 2014 and 2016, TLH was performed at the Shimane University Hospital (Izumo, Japan) in 153 patients with benign tumors, including 25 cases with a large uterus (uterine weight ≥500 g).The surgical methods applied in 3 of these large uterine cervical myoma cases were investigated in detail, including techniques devised by our department. TLH was performed without enucleating myomectomy in all 3 cases; however, all 3 cases required ureterolysis, transection of the anterior layer of the vesicouterine ligament and isolation of the ureter. In conclusion, although radical laparoscopic hysterectomy is commonly performed for cervical cancer at our department, techniques used for malignant tumor surgery may prove useful for benign cases with a high level of difficulty.

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